Objetivo. Comparar a qualidade de vida relacionada à saúde (QVRS) de hemiparéticos crônicos com diferentes níveis de atividade física. Método. Níveis de atividade física foram avaliados pelo Perfil de Atividade Humana (PAH) e os indivíduos foram estratificados em três grupos: ativos, moderadamente ativos e inativos. A QVRS foi avaliada pelo Perfil de Saúde de Nottingham (PSN). ANOVA com post-hoc LSD foi utilizada para comparar a QVRS vida entre os três grupos. Resultados. Noventa e oito hemiparéticos crônicos foram incluídos (54% homens), 56±12 anos de idade e 64±53 meses pós-lesão. Vinte e seis foram classificados como inativos, 55 moderadamente ativos e 17 ativos. Observou-se diferença na QVRS entre os três diferentes grupos de atividade física (p<0.01), sendo que grupos mais ativos apresentaram melhor percepção de QVRS. Observou-se diferença entre as três categorias de níveis de atividade física para todos os domínios de QVRS: nível de energia (p=0,02), dor (p<0,01), reações emocionais (p<0,01), qualidade do sono (p=0,04) interação social ( p=0,01) e habilidades físicas (p<0,01), sendo que indivíduos ativos apresentaram maiores escores em todos os domínios. Conclusões. Hemiparéticos crônicos ativos e moderadamente ativos apresentaram melhor percepção de QVRS, e assim, o nível de atividade física deve ser considerado em abordagens que objetivam melhorar a QVRS desta população.
Introduction: Balance deficits are frequently observed in individuals with hemiparesis and lead to disabilities in daily activities, such as the ability to walk. The sit-to-stand movement is essential for independent gait, and balance is one of the main requirements for its performance. Objective: To analyse the balance parameters during the sit-to-stand movement in individuals with chronic hemiparesis, stratified according to the level of functional performance. Method: Individuals above 20 years of age with a time since the onset of the stroke of at least six months were divided into three functional groups, according to their walking speeds: Household ambulation (<0.4 m/s), limited community ambulation (0.4 to 0.8 m/s), and complete community ambulation (>0.8 m/s). The following balance parameters were assessed by the sit-to-stand test of the Balance Master System: (1) weight transfer time, (2) rising index, and (3) the centre of gravity sway velocity. It was considered a significance level of α<0.05. Results: Eight-six individuals (56±13 years) participated. Statistically significant differences regarding weight transfer time were observed only between the household group and the others (limited community ambulation and complete community ambulation (F=4.42;p=0.01). Similarly, regarding the rising index, significant differences were observed only for the household ambulation group (F=8.46;p<0.01). Conclusion: Individuals with chronic hemiparesis, who had lower functional performance levels (household ambulation) spent more time to perform the sit-to-stand movement with less weight transfer to the lower limbs. These findings suggest that within clinical contexts when balance training is carried out to improve mobility and gait performance in individuals with household ambulation, parameters related to the transfer time and rising index should be emphasized.
Objetivo: Sumarisar as propriedades psicométricas e a utilidade clínica de instrumentos de coordenação motora (CM) dos membros superiores, que consideram a velocidade e aqualidade dos movimentos, para hemiparéticos. Procedimentos Metodológicos: Foi realizada uma busca computadorizada nas bases de dados Medline, EMBASE, PsynINFO, CINAHL, Web of Science, LILACS, SciELO, PEDro, Cochrane e OT Seeker e uma busca manual. Dois autores independentes realizaram a extração dos dados. Resultados: A estratégia de busca inicial retornou 2.152 estudos, sendo que 2.116 foram excluídos. A busca manual retornou sete estudos e assim, o número total de estudos incluídos foi 43. As propriedades psicométricas dos 16 instrumentos encontrados apresentaram, no geral, valores adequados, no entanto somente seis reportaram valores para todas. A utilidade clínica revelou que nem todos os testes são rápidos, baratos e práticos para serem utilizados. Conclusões: A deficiência na literatura deestudos que investiguem as propriedades psicométricas de teste de CM dos MMSS pode limitar a interpretação e utilização destes intrumentos na prática clínica e pesquisa. Além disso, a utilidade é um importante fator que deve interferir na escolha do instrumento.
Objective. To compare the health-related quality of life (HRQoL) of chronic stroke with various levels of physical activity. Method. Physical activity was assessed by the Human Activity Profile (HAP), and subjects were stratified into three groups: active, moderately active and inactive. HRQoL was assessed by the Nottingham Health Profile (NHP). ANOVA with post-hoc LSD was used to compare the HRQoL life among the three groups. Results. Ninety-eight chronic stroke were included (54% men), 56±12 years old and 64±53 months post-stroke. Twenty-six were classified as inactive, 55 as moderately active and 17 as active. A significant difference was observed in HRQoL between the three groups of physical activity (F =17.8 , p<0.01), with active groups showing better perceived HRQoL. A significant difference between the three categories of physical activity levels for all domains of HRQOL were observed: energy level (F=4.21, p=0.02 ), pain (F=9.13, p<0,01 ), emotional reactions (F=5.51, p<0.01), sleep quality (F=3.21, p=0.04), social interaction (F=4.42 , p=0.01) and physical skills (F=36.97, p<0.01). Conclusions. Active chronic stroke showed better perceived HRQoL, and thus the level of physical activity should be considered in approaches that aims to improve HRQOL in this population.
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